16例肺血栓栓塞猝死的法医学分析和临床研究

Forensic analysis and clinical research in 16 cases of fatal pulmonary thromboembolism

目的分析肺动脉血栓栓塞(pulmonary thromboembolism,PTE)猝死的法医病理学特点,探讨医疗过程中发生PTE的危险因素,为临床预防、治疗提供帮助。方法对本市2002年至2009年16例PTE猝死案件进行回顾性分析。结果每例均至少存在1项已知的高危因素,其中外伤12例,慢性疾病长期卧床1例,手术3例;发病到死亡的时间平均为1.2h,6例≤1h,3例≤12h。结论对于高龄(≥40岁)外伤或手术患者,预防、早期诊断和治疗PTE对于患者的生命至关重要,发现深静脉血栓形成者应采取紧急手段处理栓塞,谨防发生PTE致猝死。

Objective To analyze the forensic pathological characteristics of sudden death caused by pulmonary thromboembolism and explore the risk factors of pulmonary thromboembolism,which may give some evidence to the prevention and treatment of pulmonary thromboembolism.Methods 16 cases collected in Haimen City from the year of 2002 to 2009 were reviewed.Results There was at least one of the known risk factors in each case,12 cases were caused by trauma,3 cases were caused by surgery and 1 case had a long illness of chronic disease.The average time from presenting symptom to death was 1.2 hour,6 cases equal or less than 1 hour and 3 cases equal or less than 12 hour.Conclusion It is important to prevent pulmonary thromboembolism in patients with trauma or surgery,especially in those patients aged equal or more than forty years.Early diagnosis and treatment was also very important.Emergency treatment is necessary for thromboembolism in deep vein to prevent the sudden death of pulmonary thromboembolism.